In many pathological conditions, unwanted material exists in the body. A few of the examples include: tumors growing at cancerous sites, excess fluid at a site of infection or injury, foreign biological material within a parasitic cyst, and herniation of a tissue, such as the nucleus pulposus of the intervertebral disc. Removal of the unwanted material, which can be performed by a variety of known methods, may relieve the symptoms of the pathology, for example by reducing the pressure of inflammation, or by shrinking a herniation. Removal alone, however, may not offer any protection against recurrence of the pathology. In the intervertebral disc, for example, herniation of the nucleus pulposus may be caused by weakening of or damage to the annulus fibrosus, the ring of tissue surrounding the nucleus; removal of herniated material of the nucleus pulposus may relieve pressure within the disc, but if the annular wall remains weak, herniation may recur.
Energy delivery is used to treat various pathologies and can, among many other uses, be used to kill cells, lesion tissue, disrupt neural function, and cause collagen contraction. For example, energy delivery may be used to treat fissures and tears in the annulus fibrosus of the intervertebral disc by causing collagen contraction and remodeling to tighten, strengthen, and weld the material of the annulus fibrosus. If the disc is herniated, however, material may need to be removed from the herniation or from other areas of the disc, in order to change the profile of the disc, and reduce the disc volume, prior to heating. In some cases, following delivery of energy to the tissue, for example, to kill tumor cells, it may be desirable to remove the necrosed tissue from the treatment site. Thus, it would be beneficial to have a treatment procedure incorporating both the removal of material as well as the delivery of energy during the course of a single procedure.